Older Citizens and End-of-Life Care ─ Social Work Practice Strategies for Adults in Later Life

Older people are, like younger people, citizens in the communities of the nations in which they live. Citizenship implies a solidarity among everyone in their nation, but also a recognition that our individual identity drawn from our life experience and social relationships differentiates us from others in different groups. Should older people have special entitlements because of a special status and identity within citizenship? Does dependence on services make them lesser citizens? Does illness, frailty, disability and reaching the end of life make a difference to their citizenship? This book argues that older people retain full citizenship for the whole of their lives but what does this mean for health and social care? In this groundbreaking book, Malcolm Payne acknowledges both the common and the special aspects of the citizenship of older people and argues that current models for the provision of social work are inadequate because they incorporate dependency-creating psychosocial values, and they rely on values of participative autonomy that fail to deliver the human rights of citizenship for older people. The failure to recognise the end of life as a crucial parameter in providing social care for older people means that the lessons learned in providing palliative and end-of-life care in health care have not been transferred to social care, and the priorities of end-of-life care have not been adequately encompassed in social work with older people.

Malcolm Payne is Emeritus Professor, Manchester Metropolitan University and Honorary Professor, Kingston University; formerly director of psychosocial and spiritual care, St Christopher's Hospice, London.